The number of Botswana’s intensive care unit (ICU) beds suggests the government was never ready for a pandemic such as Covid-19. Botswana has only 34 public ICU beds for its 2,3+ million population, representing a single bed for every 70,000 people.
The government was caught almost completely unprepared when the pandemic suddenly became a grave public health crisis as hospitals struggled to cope with an unprecedented influx of inpatients. The arrival of India’s Delta variant dealt a devastating blow to an already struggling public health system, with patients practically dying like flies at both public and private health facilities.
According to the Ministry of Health and Wellness the five public health facilities that make up then 34 ICU beds are Princess Marina Referral Hospital, Nyangabgwe Referral Hospital, Mahalapye District Hospital, Sekgoma Memorial Hospital, and Scottish Memorial Hospital. When these government health facilities reach their full capacity (as was the case with covid-19 the government spends an average of P22 million annually to send patients to private hospitals for intensive care services.
The private sector does not offer enough capacity either particularly during pandemics as evidenced by the influx of critically ill patients over the Covid-19 period. Sunday Standards estimates the cumulative number of adult ICU beds for private hospitals to be more or less the same as that of public facilities. Francistown Academic Hospital offers five ICU beds, Riverside Private Hospital (also Francistown) has a capacity of four beds, and Gaborone Private Hospital has 10 adult ICU beds, while newly opened Maun Private Hospital offers no ICU services yet. Bokamoso Private Hospital and Sedilega Private Hospital would not share with this publication their ICU capacity.
While the government did the utmost in terms of interventions to manage the progression of the pandemic such as testing, contact tracing programmes, screening, provision of personal protective equipment (PPEs), isolation, hospitalisation for Covid-19 patients, the efforts fell far short in relation to provision of ICU facilities. If the pandemic has brought anything to light, it is the fact that Botswana lacks sufficient ICU capacity.
The shortfall in ICU beds was particularly evident at the height of the delta variant from May to August 2021. Both public and private health facilities struggled to cope with the influx of terminally ill patients over the period. There were at least 1,913 deaths recorded in the six months between March 1st and September 1st 2021. The numbers represent an average daily Covid-19 mortality rate of 10.6 daily deaths from March to September this year.
President Mokgweetsi Masisi acknowledged the devastating surge during one of his recent Covid-19 updates.
“COVID-19 cases in Botswana have rapidly increased over the past five months,” Masisi told the nation in mid-July 2021. “We have recorded eighty thousand one hundred and fifty-four cases (80 154) positive cases, with eight thousand nine hundred and seventy (8 970) active cases. Sadly, we lost one thousand two hundred and fifty-three (1253) people to the pandemic as at July 12th 2021, compared to three hundred (300) in February 2021.”